Geriatric Nursing · Jul 1, 2025

Social participation enhances activities of daily living capacity of older adults with multimorbidity more than in healthy non-participants

By Ojijieme NG, Chui CM

BACKGROUND: The increasing population of older adults living with long-term disability and multimorbidity requires the investigation of affordable and amenable strategies. OBJECTIVE: We investigate social participation's efficacy in mitigating the effects of multimorbidity on the Activities of Daily Living (ADL) of Chinese older adults. METHODS: We employed mixed effects modeling (MEM) to analyze data from four waves of China Health and Retirement Longitudinal Study (CHARLS), involving 9161 Chinese older adults aged 60 to 111 years, who contributed 36,644 observations. RESULTS: Results show that cardiometabolic, neurological, musculoskeletal, respiratory, cancer, and kidney conditions result in 0.157, 0.308, 0.285-, 0.219-, 0.368-, and 0.333-unit declines in ADL, respectively. Social participation significantly moderates the negative effects of multimorbidity on ADL. These effects are pronounced for older adults with neurological and respiratory conditions. Remarkably, older adults with multimorbidity who engage in social participation show greater improvement in ADL over time compared to their healthier counterparts (without multimorbidity) who do not participate in social activities. CONCLUSIONS: These findings provide measurable and evidence-based strategies to enhance long-term ADL among older adults. PRACTICE IMPLICATIONS: To enhance the Activities of Daily Living (ADL) among older adults susceptible to sedentary lifestyles, the Chinese government should implement programs that actively involve retirees in culturally relevant social participation activities. Intensifying initiatives such as educational courses tailored for older adults, and community-based volunteer opportunities can significantly promote physical health and social participation. By fostering environments that encourage active social participation, these programs can contribute to healthier and more fulfilling lives for the aging population.

doi.org/10.1016/j.gerinurse.2025.103441Open accessPubMed 40614285Populations